6 Types of Urinary Incontinence
If you struggle with urinary incontinence (UI), you are not alone. Over 33% of those over 65 deal with urinary incontinence and understand what it’s like to live with UI. In addition to being aware of what incontinence products and exercises are available, it’s important to be aware of the different types of UI, their causes, and their symptoms. When you understand urinary incontinence, you can learn how to combat it and regain control of your life.
Causes of Urinary Incontinence
There are numerous forms of urinary incontinence, and each has its own set of causes, symptoms, and ways to treat it.
#1: Stress Incontinence
According to Harvard Health, stress incontinence is characterized by urine leaks caused by movement. The term “stress” refers to physical stress placed on the bladder during sudden movements. These movements can include jumping, coughing, laughing, or sneezing. The pelvic floor muscles are the muscles that control the bladder and contract the urethral sphincter.
If you experience stress incontinence, these muscles have been weakened or damaged, and can no longer contract the way they are supposed to in order to hold urine.
There are two subgroups of stress incontinence.
The first is known as urethral hypermobility. This subtype is characterized by the movement. In urethral hypermobility, the urethra and bladder shift downward when abdominal pressure rises (due to a cough or sneeze) so the pelvic floor muscles cannot support the bladder or urethra.
The second form of stress incontinence is intrinsic sphincter deficiency. This subtype of stress incontinence happens when there are problems in the urinary sphincter that inhibit the full closure of the urinary sphincter. These problems could also allow the sphincter to “pop” under enough pressure, so if you cough hard enough or jump high enough, these muscles “pop” open and your bladder can empty.
Causes of Stress Incontinence
One of the most common causes of stress incontinence is childbirth. For mothers who gave birth vaginally, damage to the pelvic floor muscles and nerves is very likely. If your child was over average size, there’s also a greater risk of nerve and pelvic floor muscle damage.
Another cause of this form of incontinence is age. As we age, our muscles generally weaken. Unfortunately, this does not exclude our pelvic floor muscles and the urethral sphincter. In women, this can be due to an imbalance of estrogen levels, which can lead to bone and muscle loss. For men, stress incontinence is most often caused by urinary sphincter damage from a prostate surgery or injury.
In addition, there are other contributing factors to developing stress incontinence such as obesity and high impact exercise. Lung conditions or respiratory issues caused by smoking or disease can also lead to stress incontinence as they may cause an increase in coughing.
Signs and Symptoms of Stress Incontinence
- You will not feel the urge to urinate
- Urinating when you cough or sneeze
- Urinating when you laugh, bend over, or lift something heavy
- Urinating during exercise or sex
#2: Urge Incontinence
Also known as overactive bladder incontinence, this form of incontinence is characterized by the urge to urinate, even if your bladder isn’t completely full. A muscle called the detrusor muscle is responsible for signaling to the brain that you have to urinate.
This overactivity occurs when the detrusor muscle contracts and signals urgency even when your bladder is not full. The signal for urgency is often very short lived and your bladder muscles may release before you can make it to the restroom.
Causes of Urge Incontinence
The causes of urge incontinence are less identifiable than those of stress incontinence. Urge incontinence could be caused by brain damage, which could prevent you from being able to counteract the signals sent to your brain to release your bladder. Similarly, if you’ve suffered from nerve damage or spine damage, these could result in an inability to stop a signal. Urinary infection could also cause urge incontinence and increase the urge to go, but these often go away when your infection does.
When women go through menopause, their pelvic floor muscles also often get weaker. This is due to a few factors. Their body produces significantly less estrogen, the hormone responsible for the menstrual cycle, pregnancy changes and puberty. When the body stops making this hormone, women stop going through these changes, and as a result, the vaginal tissue becomes less elastic, the urethra lining may begin to thin, and the pelvic floor muscles weaken.
In addition, if you have myofascial pelvic pain syndrome, you may experience urge incontinence as a result. If you experience burning when urinating, pain or feelings of heaviness in your bladder, speak to your physician.
In men, urge incontinence is most commonly caused by surgeries to or damage to the prostate. This can include benign prostatic hyperplasia (BPH) which is enlargement of the prostate, prostate cancer surgeries, or other prostate cancer procedures and treatments.
Signs and Symptoms of Urge Incontinence
- An increased urge to urinate, even if you have just emptied your bladder
- An inability to control these urges or wait
- Being unable to make it to the bathroom in time
#3: Mixed Incontinence
Some people experience both stress incontinence and urge incontinence, and this is referred to as mixed incontinence. Mixed incontinence is most common in women due to menopause and childbirth. Men can experience mixed incontinence if they have had surgeries or damage to the prostate as well.
Your chances of experiencing mixed incontinence also increase as you age, so understanding the signs of each type of UI and learning how to deal with it can be a determining factor in your journey.
#4: Overflow Incontinence
Overflow incontinence is most often experienced in men. It can be caused by a blockage of complete urine passage, which prohibits the bladder to empty completely, thus causing leaks without the urge to urinate. This form of UI can also be caused by weakening of the pelvic floor muscles or bladder inactivity.
Causes of Overflow Incontinence
If you have had a urine drainage bag, you may experience overflow incontinence due to the inactivity of your bladder.
Bladder stones or urinary tract tumors can also cause overflow incontinence as they block the urinary tract and can prevent complete emptying of the bladder.
Some medicines can even result in overflow incontinence.
If you notice a change in your urinary habits after starting medicine, speak to your physician.
Signs and Symptoms of Overflow Incontinence
- Releasing urine suddenly without the urge to go
- Feeling like your bladder is full even after urination
- Urination leakage while sleeping
- Sudden stopping and starting of your urine stream while you’re urinating
- Difficulty urinating even when you feel the urge to go
#5: Reflex Incontinence
Reflex Incontinence is characterized by the release of urine with no warning or urging. You will not feel like you need to urinate, and you may not even realize you’re leaking until you feel wet.
Typically, reflex incontinence is due to nerve damage of the nerves responsible for signaling bladder fullness or emptiness. The most common appearance of this form of urinary incontinence is in people with severe brain damage or spinal cord damage, those with multiple sclerosis, or those who have undergone radiation treatments or specific surgeries.
#6: Functional Incontinence
Function Incontinence is actually characterized by your urinary system being able to function, but damage to your brain function. This can be caused by a mental health condition, certain medications that may affect your sense of reality, or brain damage incurred in an accident or surgery.
This form of UI is also sometimes present in those with simple difficulty getting to the restroom. If you are downstairs and your bathroom is upstairs, you may experience trouble getting up the stairs to use the bathroom, and this can cause incontinence.
Living with Urinary Incontinence
Living with urinary incontinence can cause emotional distress, loss of sleep, lack of nutrition, and skin rash and irritation. Despite how common UI is among older adults, the stigma around UI can make it difficult for you to find the products you need and exercises to best help you.
If you live with urinary incontinence, you deserve products that fit into your life seamlessly. From protective underwear that fits your lifestyle, to skin products you can integrate effortlessly into your busy life to protect you from rash and irritation, we know how important it is to be prepared.
Additionally, pelvic floor exercises (kegel exercises) can help you regain some control of your UI and your life. Kegels are easy to perform, requires little effort, and can be done while watching TV, brushing your teeth, or even washing the dishes!
Being aware of the signs, symptoms and causes of urinary incontinence will help you understand which form you experience or may be susceptible to. Thankfully, there are a wealth of resources and tools to help you comfortably live with UI, because you have better things to do than worry about a leak!